Nursing Ethics

This important text draws on decades of research, arguing that modern nursing germinated and grew an ethics from its own native soil, that is a rich, fulsome and philosophically informed; grounded in the tradition, and practice of nursing. This systematic and comprehensive book is an essential contribution for students and scholars of nursing ethics.

A patient is diagnosed with the persistent vegetative state (PVS) when they show no evidence of the awareness of the self or the environment for an extended period of time. The chance of recovery of any mental function or the ability to interact in a meaningful way is low. Though rare, the condition, considering its nature as a state outwith the realm of the conscious, coupled with the trauma experienced by the patient's kin as well as health care staff confronted (...) with painful decisions regarding the patient's care, has attracted a considerable amount of discussion within the bioethics community. At present, there is a wealth of literature that discusses the relevant neurology, that elucidates the plethora of ethical challenges in understanding and dealing with the condition, and that analyses the real-world cases which have prominently featured in the mainstream media as a result of emotionally charged, divergent views concerning the provision of care to the patient. However, there is scarcely anything in the published scholarly literature that proposes concrete and practically actionable solutions to the now widely recognized moral conundrums. The present article describes a step in that direction. I start from the very foundations, laying out a sentientist approach which serves as the basis for the consequent moral decision-making, and then proceed to systematically identify and deconstruct the different cases of discord, using the aforementioned foundations as the basis for their resolution. A major intellectual contribution concerns the fluidity of the duty of care which I argue is demanded by the sentientist focus. The said duty is shown initially to have for its object the patient, which depending on the circumstances, can change to the patient's kin, or the health care staff themselves. In conclusion, the proposed framework represents the first comprehensive proposal regarding the decision-making processes involved in the deliberation on the provision of life sustaining treatment to a patient in a PVS. (shrink)

The sacrifices of nurses in hard-hit cities during the early stages of the COVID-19 pandemic and of family caregivers for people with late-stage Alzheimer’s disease present two puzzles. First, traditional accounts of supererogation cannot allow for the possibility of making enormous sacrifices that make one’s actions supererogatory simply to do what morality requires. These caregivers, however, are doing their moral duty, yet their actions also seem to be paradigmatic cases of supererogation. I argue that Dale Dorsey’s new account of supererogation (...) can solve this puzzle. Second, these caregivers often deny that they are heroic, but standard explanations of these assertions either diminish their sacrifice, say they are confused, or attribute to them a vice. If we want to understand them without diminishing them, we should instead see their denials as a response to what Beth DeVolder calls compulsory heroism. Compulsory heroism occurs when someone is foisted into the role of hero for doing their moral duty as a distraction from the social realities that make doing their duty involve inordinate sacrifice. (shrink)

Ethics and the Good Doctor brings together existing literature and an analysis of empirical research conducted by the Jubilee Centre for Character and Virtues to examine the ethical nature of medical practice and explore medicine as a virtuous profession. The book is based on the idea that medical practice is an inherently moral profession, in which notions of trust, care and meaningful relationships form the foundations of being a good doctor. By taking into account the ethical dimensions of medical practice (...) that have come under greater scrutiny and pressure over recent years, this book explores how personal and professional character is understood, enacted, and experienced by medical practitioners at various stages of their career. Ethics and the Good Doctor situates and presents the empirical data in a way that is accessible to practicing doctors, medical students, and medical educators. Clear implications for policy, practice, and research are offered, ensuring this book will be of great interest to a range of stakeholders involved in medical practice, including those working in medical policy. (shrink)

An ethics primer for nurses and nursing students that advances a vision for a holistic Christian notion of health and explores what Christian faith means, on a practical level, for the practice of nursing.

Now in its sixth edition, this highly popular text covers the range of ethical issues affecting nurses and other healthcare professionals. Authors Simon Robinson and Owen Doody take a holistic and practical approach, focused in the dialogue of ethical decision making and how this connects professional, leadership and governance ethics in the modern healthcare environment. This focuses on the responsibility of professionals and leaders, and the importance of shared responsibility in the practice of healthcare. With a foreword by the eminent (...) medical ethicist Alastair Campbell, the revised edition includes contemporary topics, such as the duty of candour, recent cases, such as the Mid Staffs scandal, and ethical perspectives on vulnerable groups, such as; persons with intellectual/learning disability, dementia and those with an enduring mental illness. It builds on professional identity and personal development as part of ongoing learning, individual and organizational, and provides interactive ways that helps the reader to develop reflective ethical practice. This text aims to enable ethical engagement with the ever changing healthcare environment, and is a must-have for anyone serious about ethics in healthcare. Holistic and practice relevant approach New perspectives on vulnerable groups, such as persons with intellectual/learning disability, dementia and those with an enduring mental illness Descriptive as well as normative ethical theory Promoting dialogue and engagement with practice, practitioners, patients and families Development of professional ethical skills Connecting professional ethics to leadership, governance and social ethics Highly accessible format Case studies/Scenarios presented within chapters and pause for thought exercises to promote dialogue and engagement? Suitable for pre/post registration nurses, students, health care professionals. (shrink)

The phrase ‘person‐centred care’ (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood. However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood in which (...) a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC. (shrink)

Healthcare delivery can present ethical conflicts and dilemmas for advanced practice registered nurses (APRNs)--nurses who already have a myriad of responsibilities in caring for patients. Ethical Case Studies for Advanced Practice Nurses improves APRNs' agility to resolve ethical quandaries encountered in primary care, hospital-based, higher education, and administration beyond community settings. Through case studies examining various types of ethical conflicts, the authors empower APRNs and students with the critical knowledge and skills they need to handle even the most complex dilemmas (...) in their practice. By applying a set of criteria and framework, this book guides APRNs to use critical thinking to make ethically sound decisions. Case study topics include: substance use in pregnancy, elder-care issues, depression screening in adolescents, abortion and moral values, medical emancipation versus confidentiality in transgender and gender-nonconforming people, prescription refills for patients with financial hardship. (shrink)

Aims and Objectives The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. -/- Background Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well-being and patient care. However, there is no thorough conceptual understanding of this concept. -/- Design Concept analysis. -/- Methods Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies (...) between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA-ScR checklist to report the study. -/- Results Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. -/- Conclusions A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. (shrink)

The nursing community in the United States polarized in September 2020 between Dawn Wooten's whistleblowing about forced hysterectomies at an immigration center in Georgia and the American Nurses Association's refusal to endorse a presidential candidate despite the Trump administration's mounting failures to address the public health crisis posed by the COVID‐19 pandemic. This reveals a need for more attention to political aspects of health outcome inequities. As advocates for health equity, nurses can join in recent scholarship and activism concerning the (...) political determinants of health. In this paper, we examine recent work on the political determinants of health with an aim to add two things. First, we seek to build further on the notion of “political” determinants of health by distinguishing policy and governance structures from dynamics of politicization through appeal to critical disabilities studies. Second, we seek to apply this further nuanced approach to challenge rhetorical uses of “vulnerable populations,” where this phrase serves to misrecognize systemic institutionalized forces that actively exploit and marginalize people and groups. By refocusing attention to political systems organized around and perpetuating inequitable health outcomes, nurses and other health care professionals—as well as those whom they serve—can concentrate their effort and power to act on political determinants of health in bringing about more equitable health outcomes. (shrink)

As nursing and healthcare continue to change, we need nurses who are committed both to a solid understanding of their profession and to caring well for patients and their families. Offering a historically and theologically grounded vision of the nurse's call, this thoroughly revised third edition of a classic text includes practical features for educators, students, and practitioners.

"In this continuing work, I have allowed myself to incorporate personal material...for my own caring-healing processes...So, in some ways, writing about caring and sacred science may not be tolerated in academic circles and scholarly work, but if there was ever a time to converge personal and professional authentic ethical efforts for living/being/doing/becoming scholarly, spirit-filled and scientific, it is NOW." Jean Watson Written by the leading expert in Caring Science Dr Jean Watson, this updated newly revised text offers a moral and (...) philosophical foundation for all health professionals. This moral/ethical framework offers the reader a way to work and view life through a caring and healing lens. The author discusses a new paradigm for mind-body-spirit nursing, medicine and healthcare. You will gain core knowledge of caring as it relates to both education and the practice of compassionate, professional human caring and healing. This new edition includes Watson's most recent writings on the Seven Sacred Sutras as well as her 10 Caritas Processes(R), a foundational, values-based guide in which to base your life and work. (shrink)

Learn how to think beyond the theoretical in any environment. "Ethics & Issues in Contemporary Nursing, 1st Edition" examines the latest trends, principles, theories, and models in patient care to help you learn how to make ethically sound decisions in complex and often controversial situations. Written from a global perspective, examples throughout the text reflect current national and international issues inviting you to explore cases considering socio-cultural influences, personal values, and professional ethics. Historical examples demonstrate how to think critically while (...) upholding moral and professional standards, as well as the law. Key topics throughout explore advocacy and rights, diversity, nurse burnout, mass casualty events, social media, violence in the workplace, medication error prevention, opioid and other substance use, HIPAA, and healthcare reform. In addition, this new title contains supplemental case studies and review questions to further challenge and prepare you to make morally sound decisions in any healthcare setting. -- From product description. (shrink)

First published in 1997, this volume responds to the rapidly developing fields of nursing and health care fields and explores the meaning of nursing and the nurse-patient relationship through looking at the effects of a nurse's personality, approach and understanding as being therapeutic for the patient's experience. Steven J. Ersser explores areas including the concept of nursing as therapy, the presence of nurses and the effect of nursing on patient outcome. His book is part of a new series of monographs (...) offering up-to-date reports of recently completed research projects in the fields of nursing and health care. The aim of the series is to report studies that have relevance to contemporary nursing and health care practice. It will include reports of research into aspects of clinical nursing care, management and education. This book, along with the series, will be of interest to all nurses and health care workers, researchers, managers and educators in the field. (shrink)

Empathy is a topic of continuous debate in the nursing literature. Many argue that empathy is indispensable to effective nursing practice. Yet others argue that nurses should rather rely on sympathy, compassion, or consolation. However, a more troubling disagreement underlies these debates: There’s no consensus on how to define empathy. This lack of consensus is the primary obstacle to a constructive debate over the role and import of empathy in nursing practice. The solution to this problem seems obvious: Nurses need (...) to reach a consensus on the meaning and definition of empathy. But this is easier said than done. Concept analyses, for instance, reveal a profound ambiguity and heterogeneity of the concept of empathy across the nursing literature. Since the term “empathy” is used to refer to a range of perceptual, cognitive, emotional, and behavioral phenomena, the presence of a conceptual ambiguity and heterogeneity is hardly surprising. Our proposal is simple. To move forward, we need to return to the basics. We should develop the concept from the ground up. That is, we should begin by identifying and describing the most fundamental form of empathic experience. Once we identify the most fundamental form of empathy, we will be able to distinguish among the more derivative experiences and behaviors that are addressed by the same name and, ideally, determine the place of these phenomena in the field of nursing. The aim of this article is, consequently, to lay the groundwork for a more coherent concept of empathy and thereby for a more fruitful debate over the role of empathy in nursing. In Part 1, we outline the history of the concept of empathy within nursing, explain why nurses are sometimes warry of adapting concepts from other disciplines, and argue that nurses should distinguish between adapting concepts from applied disciplines and from more theoretical disciplines. In Part 2, we show that the distinction between emotional and cognitive empathy—borrowed from theoretical psychology—has been a major factor in nurses’ negative attitudes toward emotional empathy. We argue, however, that both concepts fail to capture the most fundamental form of empathy. In Part 3, we draw on and present some of the seminal studies of empathy that can be found in the work of phenomenological philosophers including Max Scheler, Edmund Husserl, and Edith Stein. In Part 4, we outline how their understanding of empathy may facilitate current debates about empathy’s role in nursing. (shrink)

Transhumanism is a movement that seeks to transcend certain limitations inherent in the human condition as we know it. But does it justify overriding the dignity of current human beings in order to satisfy the desire to increase human potential and improve human beings as such, in order to obtain other human beings? Does it justify disregarding the dignity of women in order to obtain new human beings through fertilization? To answer these questions, we have made a sweep over the (...) ideas of transhumanism that drive this type of techniques, to later understand the vision that women have in the use of in vitro fertilization, the hidden discrimination under these procedures and the clarification of the true emancipation and restoration of women's rights in relation to the use of in vitro fertilization. -/- El transhumanismo es un movimiento que busca trascender ciertos límites inherentes a la condición humana como la conocemos. Sin embargo, ¿justifica dejar de lado la dignidad de los seres humanos actuales por cumplir el deseo de aumentar el potencial humano y mejorar al ser humano como tal para obtener otros seres humanos?, ¿justifica pasar por encima de la dignidad de una mujer para obtener nuevos seres humanos a través de la fertilización in vitro? Para responder a estas preguntas hemos hecho un barrido sobre las ideas del transhumanismo que impulsa este tipo de técnicas, para luego comprender la visión que se tiene de la mujer en el uso de la fertilización in vitro, la discriminación oculta bajo estos procedimientos y la aclaración de la verdadera emancipación y restablecimiento de los derechos de la mujer en relación con el uso de la fertilización in vitro. (shrink)

Nurses are positioned on healthcare's front line, intimately connected to individuals, families, and communities. How can they leverage this position to work for the common good? In Toward ward a Better World, Mark Lazenby, a philosopher and a nurse, presents a plan of action. He argues that nurses advance the good society when they fulfill fundamental obligations. Promoting equality, peace and respect, providing assistance and safety, and safeguarding the health of our planet are among these obligations. By acting upon them, (...) nurses become a force for social change in their communities. But through the collective power of more than 20 million nurses worldwide, nurses become a global force for making the world a better place--in the present and for the future. (shrink)

Nurses and other medical practitioners often experience moral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies (...) something important that the phenomenon of moral distress tells us. In fact, both the practitioners’ tendencies to hold themselves responsible and other people’s reluctance to hold the practitioners responsible get something right. The practitioners may be right that they are responsible in the sense of having failed to meet a binding moral requirement, even when the requirement was impossible to meet. This makes moral distress a fitting response because it correctly represents their own action as a wrongdoing. However, others may meanwhile be right that the practitioners are not responsible in the sense of being culpable and blameworthy. To blame others, or oneself, for certain failures, including those that are unavoidable, would be unfair. My claim depends on distinguishing between the fittingness and the fairness of holding someone (including oneself) responsible for moral failure. Having drawn the distinction, I suggest that moral distress should be addressed in a way that both recognizes it as a fitting response and avoids the unfairness of blame. (shrink)